J Randall Patrinely1, Elisa Funck-Brentano2, Khang Nguyen3,4,5,6, Suthee Rapisuwon7, Joe-Elie Salem8, Geoffrey T Gibney7, Matteo Carlino3,4,5,6, Douglas B Johnson9. 1. School of Medicine, Vanderbilt University, Nashville, Tennessee, USA. 2. Université de Versailles-Saint-Quentin-en-Yvelines, Université Paris-Saclay, Biomarkers in Cancerology and Hemato-oncology, Department of General and Oncologic Dermatology, Ambroise-Paré Hospital, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France. 3. Department of Medical Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia. 4. Centre for Cancer Research, Westmead Millennium Institute, Westmead, New South Wales, Australia. 5. Melanoma Institute Australia, Sydney, New South Wales, Australia. 6. The Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia. 7. Department of Medicine, Georgetown University Hospital, Washington, DC, USA. 8. Department of Pharmacology, Assistance Publique - Hôpitaux de Paris, Sorbonne Universités, Paris, France. 9. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Abstract
BACKGROUND: The objective of this work was to characterize outcomes of patients with isolated brain metastases managed with local therapy followed by immune checkpoint inhibitor (ICI) therapy. MATERIALS AND METHODS: Patients from four medical centers were included if they presented with isolated brain metastases treated with local therapy and received adjuvant treatment with ICIs. RESULTS: Eleven patients with median size of largest brain metastasis of 3.9 cm, treated with surgical resection (n = 8) and/or stereotactic radiosurgery (SRS; n = 6), were included. Ipilimumab/nivolumab was the adjuvant ICI used in four patients, of whom one recurred (25%) and none died, compared with three of seven (43%) who recurred and two of seven (29%) who died following adjuvant treatment with ICI monotherapy. All recurrences were intracranial. CONCLUSION: Patients with isolated brain metastases treated with surgery or SRS appeared to benefit from adjuvant ICI therapy, particularly with combination therapy. Recurrences in this setting appear to largely occur intracranially.
BACKGROUND: The objective of this work was to characterize outcomes of patients with isolated brain metastases managed with local therapy followed by immune checkpoint inhibitor (ICI) therapy. MATERIALS AND METHODS:Patients from four medical centers were included if they presented with isolated brain metastases treated with local therapy and received adjuvant treatment with ICIs. RESULTS: Eleven patients with median size of largest brain metastasis of 3.9 cm, treated with surgical resection (n = 8) and/or stereotactic radiosurgery (SRS; n = 6), were included. Ipilimumab/nivolumab was the adjuvant ICI used in four patients, of whom one recurred (25%) and none died, compared with three of seven (43%) who recurred and two of seven (29%) who died following adjuvant treatment with ICI monotherapy. All recurrences were intracranial. CONCLUSION:Patients with isolated brain metastases treated with surgery or SRS appeared to benefit from adjuvant ICI therapy, particularly with combination therapy. Recurrences in this setting appear to largely occur intracranially.
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